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#4518315 - 04/27/20 11:51 AM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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Anti-virals have to be used early, Tamiflu is another example.

Therefore, I don't understand the point of using Hydroxy late in treatment, like the NIH has decided to do. They know this, and this makes me wonder why. They are set up for failure already.


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#4518832 - 04/30/20 01:11 PM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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New research out of Italy on people who take Hydroxy for chronic arthritis and lupos, studying whether it can used as a prophylactic.


https://www.iltempo.it/salute/2020/...pia-idrossiclorochina-sars-cov2-1321227/



Finally, further confirmation of this hypothesis is the data collected in the register of the SIR (Italian rheumatology society). To assess the possible correlations between chronic patients and Covid19, SIR interrogated 1,200 rheumatologists throughout Italy to collect statistics on infections. Out of an audience of 65,000 chronic patients (Lupus and Rheumatoid Arthritis), who systematically take Plaquenil / hydroxychloroquine, only 20 patients tested positive for the virus. Nobody died, nobody is in intensive care, according to the data collected so far.


"College graduates should not have to live out their 20s in their childhood bedrooms, staring up at fading Obama posters and wondering when they can move out and get going with life" - Paul Ryan
#4518960 - 05/01/20 06:37 AM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: Nixer]  
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Originally Posted by Nixer
The VA didn't use Zinc?


Not only that, but they were late stage trials. If you don't take Tamaflu in the first day or two, you might as well not. The goal is to give the anti-viral as the virus is starting to replicate to then suppress it. If you use it after it already has, it isn't giving the time for the body to build anti-bodies, the infection is already well established.

It was a horribly politicized study.


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#4518974 - 05/01/20 10:48 AM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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Some South Korean numbers with Hydroxy.

https://www.sciencedirect.com/science/article/pii/S092485792030145X

In a Korean nursing home, 189 residents (Avg. 82 yrs) were exposed to Covid-19. They were promptly treated with hydroxychloroquine. None of the residents there died. Massachusetts Nursing Home, 70 Covid patients treated with Hydroxy, none died.


"College graduates should not have to live out their 20s in their childhood bedrooms, staring up at fading Obama posters and wondering when they can move out and get going with life" - Paul Ryan
#4519284 - 05/03/20 05:44 PM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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Somewhat of a breakthrough discovery on how Covid works, if correct. Explains the illnesses, and why men are more affected.

Hydroxy is the key.

https://www.jpost.com/health-scienc...ed-main-mechanism-behind-covid-19-626737


"College graduates should not have to live out their 20s in their childhood bedrooms, staring up at fading Obama posters and wondering when they can move out and get going with life" - Paul Ryan
#4520259 - 05/09/20 04:03 PM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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Originally Posted by TerribleTwo
Somewhat of a breakthrough discovery on how Covid works, if correct. Explains the illnesses, and why men are more affected.

Hydroxy is the key.

https://www.jpost.com/health-scienc...ed-main-mechanism-behind-covid-19-626737



I'm confused by this article.
Is she a lab researcher, or a pharmacist advancing her own theories?

Quote
Chiusolo...works as a pharmacist in the European country. Her theory has been published by some of the country’s leading newspapers, including the Italian dailies Il Tempo and Il Giornale.

Published by leading newspapers in Italy? That holds absolutely no water with me.

The virus "needs porphyrins for its survival – and probably for its replication. "
How does she know this? Is this some new viral mechanism of replication?
"...so it attacks hemoglobin."
Has she done research showing this?
Again, interesting theory that I have not heard elsewhere. I'm not sure biochemically how this makes any sense, but maybe there's an explanation behind it I have not heard of.

All interesting theories but no more than that. The same article casts doubt on this theory later on.

I absolutely want hydroxychloroquine to be an effective treatment (though it is far from "harmless" as some have described it) but I'm just not seeing anything beyond anecdotal evidence supporting it anywhere.
Right now we are grasping for anything that will help our patients.

The same mechanisms that supposedly make it effective against this particular coronavirus strain should also make it effective against other viruses, but no big difference was seen in the past when it was tested against Ebola virus, influenza virus, and Dengue fever virus.
As for now, many New York hospitals that are now the most experienced in the world at treating COVID-19 patients, are turning to other methods of treatment:

Quote
"We know now it probably doesn’t help much," said Dr. Thomas McGinn, Deputy Physician-In-Chief at Northwell Health. "We’re not recommending it as a baseline therapy anymore. It is only in a treatment protocol in a study that we’re recommending it."

Hospitals began using the drug early on in hopes it could calm the overactive immune response to COVID-19. But now that little proven benefit has been found, many doctors here in New York have moved on.

Just days ago, Mount Sinai changed course.

"As of last week, we stopped using hydroxychloroquine as a routine medication in our hospital based upon the cumulative experience in our hands and in others, and recommendations by the FDA that it should not be used outside of clinical trials,” said Dr. Charles Powell, chief of the Division of Pulmonary, Critical Care and Sleep Medicine at the Mount Sinai Health System and CEO of the Mount Sinai-National Jewish Health Respiratory Institute.

...NYU Langone is now also using hydroxychloroquine only in clinical trials, where a more controlled setting will yield more reliable data.

“I was really looking for a study that showed that people who were treated with it were less likely to get intubated,” said Dr. Luke O’Donnell, attending physician at NYU Langone. “And I think more and more data is showing that there is minimal to no difference.”


https://www.ny1.com/nyc/all-borough...xychloroquine-treatment-touted-by-trump-

In time, more rigorous studies will tell the story. We will know if hydroxychloroquine, chloroquine, or azithromycin (Zithromax), are of any utility in treating COVID-19. I think the evidence is pretty clear it is not helpful for very sick patients, so right away its potential usefulness for clinicians is limited where we need it most. I do personally know a researcher at Pfizer who is studying azithromycin as a treatment for SARS-CoV-2.

I am confident we will find an effective treatment. One of the silver linings of the AIDS epidemic is that it vastly increased funding for research into antivirals and our knowledge base for treatment of viral illnesses which is now invaluable in responding to this epidemic.
But I am extremely skeptical of anyone who declares with no reservation and less evidence that they have found "the answer."


"For what shall it profit a man, if he shall gain the whole world, and lose his own soul?" -- Mark 8:36
#4520264 - 05/09/20 05:05 PM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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THE ROLE of hydroxychloroquine in the prevention and fight against coronavirus was also the subject of a study published in The International Journal of Antimicrobial Agents, which describes how a healthcare worker infected with the novel coronavirus traveled freely within a hospital before being diagnosed with the virus.
“It was not possible to quarantine everyone who had come into contact with the healthcare worker,” Chiusolo said. So, they treated 211 healthcare professionals and patients with hydroxychloroquine. After 10 days, nobody tested positive for the coronavirus.
Furthermore, Chiusolo told the Post, the Italian Society of Rheumatology interviewed 1,200 rheumatologists throughout Italy to collect statistics on contagions. Out of an audience of 65,000 chronic lupus and rheumatoid arthritis patients who systematically take hydroxychloroquine, only 20 patients tested positive for the virus.

#4520266 - 05/09/20 05:36 PM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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Most healthcare workers think in terms of treating individuals, while epidemiologists think in terms of treatment of a community.

Unfortunately, the COVID virus needs to go the way of chicken pox and get eradicated from the world via widespread vaccination and herd immunity. Drug treatments are quicker to get approved by the FDA since most are already marketed drugs, you're just applying to the FDA for a new indication. If drug treatments work, they can reduce the viral load and help patients recover faster and/or slow down the damage. But developing immunity via vaccination is like wearing a bullet proof vest against COVID. It quickly disrupts the ‘Disease triangle’ of the COVID infection.

In the long run, vaccination is more cost-effective than treatment. One source that verifies this :Cost-Effectiveness of Vaccination versus Treatment of Influenza in Healthy Adolescents and Adults, by Peter A. Muennig, Kamran Khan. Also, Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis, by Rothberg MB1, Rose DN.


Last edited by orbyxP; 05/09/20 05:42 PM.
#4520287 - 05/09/20 09:26 PM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: Mr_Blastman]  
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Originally Posted by Mr_Blastman
Quote

Furthermore, Chiusolo told the Post, the Italian Society of Rheumatology interviewed 1,200 rheumatologists throughout Italy to collect statistics on contagions. Out of an audience of 65,000 chronic lupus and rheumatoid arthritis patients who systematically take hydroxychloroquine, only 20 patients tested positive for the virus.



As a clinician, it's very frustrating to see how much misinformation is being spread so rapidly. That 65,000 number being quoted is, unfortunately, totally bogus.

Quote
One of the features of my emails has been a reference to this report in the Italian press (near the end of the article) that the Italian Rheumatological Society (SIR) has been collecting data on just this question from 1,200 physicians there. The article says that there are 65,000 patients in Italy taking HCQ chronically and that only 20 of them have tested positive for the virus. Now, you’d want to compare that to RA and lupus patients who were not taking HCQ, but it would still be quite interesting. If it were true.

But I can’t see where that figure comes from. That one Italian press report is the source that everyone else refers back to. And when I look at the SIR itself, I find that it is part of the COVID-19 Global Rheumatology Alliance, a worldwide data collection consortium. Their worldwide provider-entered database of coronavirus-positive patients says that it’s up to 1072 cases (on the front page) and 777 of those have data broken down into categories here. According to this map, 84 of these patients are in Italy (not 20 as stated in the article). The provider registry is just of people reported by physicians, and it shows that 24% of those 777 patients (188 of them) were taking antimalarials such as HCQ when they tested positive for the virus, so if that percentage holds up, then there are indeed about 21 Italian rheumatology patients taking HCQ that have have tested positive and been reported on in detail by their physicians. But as for those 65,000 Italians who are taking HCQ, I can find no evidence of that at all, and I have no idea how many of the Italian HCQ patients are being so monitored. The 65,000 number may well be coming from Italian researcher Annabella Chiusolo, interviewed here at the Jerusalem Post, but the worldwide patient survey numbers at the Rheumatology Alliance are only 11,762. The most recent breakdown of those numbers look at 9,541 patient responses, with about 28% of them were taking antimalarials, and a total of 465 coronavirus cases.

Update: here’s the answer. The number is completely fictional. As mentioned here in the comments, the president of the Italian Rheumatology Society was contacted directly and states that this number is completely wrong, that the society is monitoring 150 patients in its registry, 20 of whom are taking hydroxychloroquine. The 65,000 number is bogus.


https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hydroxychloroquine-update-may-4

Again, I would love it for hydroxychloroquine to be an effective treatment against SARS-CoV-2. I'm a physician. My wife is a nurse. We have two young kids. We have friends working in the ICU caring for COVID-19 patients right now.
But whenever the media and fanatical public advocates get involved in medicine, science goes out the window and the loudest voices get the most coverage.
I've seen this time and again.
Documentaries like "Plandemic" get widespread coverage despite their despicable abhorrence for the truth and outright slandering of anyone who disagrees with their agenda. There is little room for rational debate.
And again, if hydroxychloroquine is an effective treatment we will learn this in time. Any researcher would love to be the one in the news showing they have proven that this treatment can change the course of this pandemic. There is NOT a widespread Big Pharma conspiracy to silence researchers.
And again, early on I would have treated my patients with hydroxychloroquine in lieu of any other therapy while knowing that we don't know if it really works.
We will find a treatment. The scientific methods we have work and are why medicine has advanced so far. Keep an open mind while the evidence is collated in the meantime.


"For what shall it profit a man, if he shall gain the whole world, and lose his own soul?" -- Mark 8:36
#4520298 - 05/10/20 12:11 AM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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First study to show the addition of zinc to the Hydroxy protocol shows a statistically significant result in mortality.

https://www.researchgate.net/public...tcomes_in_hospitalized_COVID-19_patients


"College graduates should not have to live out their 20s in their childhood bedrooms, staring up at fading Obama posters and wondering when they can move out and get going with life" - Paul Ryan
#4520414 - 05/11/20 04:08 AM Re: Drug combo working. Covid. Dr Zelenko NYC hospital. [Re: TerribleTwo]  
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Originally Posted by TerribleTwo
First study to show the addition of zinc to the Hydroxy protocol shows a statistically significant result in mortality.

https://www.researchgate.net/public...tcomes_in_hospitalized_COVID-19_patients


I've downloaded the pdf and looked at this study.
Now this seems like a well constructed study. This work is promising and does not appear to have some of the glaring flaws of the original French study.
As a retrospective observational study it does not have the power of a double blind, placebo controlled prospective study, but that is to be expected at this stage when we need preliminary data as soon as possible.
I'm struck by how normal the lab tests were upon admission for these patients, some of whom later went on to the ICU and mechanical ventilation.
THIS is the kind of study we have needed to give evidentiary support to the hydroxychloroquine treatment. This hopefully moves things beyond the merely anecdotal. Again, it is promising and although it does not have the power of studies that will come later, gives some hope that this regimen may be useful.

Last edited by Docjonel; 05/11/20 04:31 AM.

"For what shall it profit a man, if he shall gain the whole world, and lose his own soul?" -- Mark 8:36
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